Traditionally, a single patient to a single physician model is used for medical treatment decisions. Especially when confronted with a complicated disease such as cancer, patients tend to rely on their local physicians for accurate diagnosis, references to specialists, advice on which treatment protocols to adopt and how to proceed. However, the patient and the patient's family are left with several important decisions to make personally. Moreover, their personal abilities to adopt and execute on any of the recommended treatment options may vary. Additionally, in matters where a decision could directly impact the longevity, quality of life, and complete cure for the patient, the decision-making abilities of the patient and family are compromised by the physical stress, anxiety, uncertainty, and lack of confidence that accompany the medical problem. Therefore, reliable information, expert opinion, and trustworthy personalized guidance become necessary to assist patients and their families in making complex medical decisions.
However, it is not trivial to obtain access to and gain an understanding of exhaustive and intensive medical information and expert opinion, especially from world leading medical institutions and repositories of medical literature. Limiting factors include intellectual abilities to understand medical information and opinion, and personal resources such as time, money, and location. Typically, patients and families rely on friends, family members, social networking groups and communities, medical encyclopedias and related websites, as well as relationships with their primary care physicians and specialist doctors for assistance in decision making. Other possibilities include second opinions from medical institutions in metropolitan cities and overseas locations known for their medical research and experience. The Internet, telemedicine and availability of online web services and concierge services to connect patients in different locations with medical experts around the world have opened up additional possibilities for patients to obtain expert opinion at premium costs. For instance, second opinions and pathology/radiology reviews from medical institutions in the United States are becoming a fairly common option pursued by patients in the upper to middle income populations in developing countries.
The efficiency, reliability, accuracy, and effectiveness of such options, however, are questionable. More importantly, none of these services provide a definitive recommendation to follow and the patient's personal preferences, resource limitations, risk tolerances, and to some extent overall medical condition often are not explicitly factored in the medical opinion. A second or third opinion is marginally useful over a primary medical opinion and each additional opinion brings with it added costs and confusions over the final decision, since opinions may be conflicting, contradictory, or unclear. In fields of medicine that are continuously evolving and where research in different parts of the world conclude on widely varying medical paths, second and third opinions can bring with it added complexity and confusion in decision making.
Patients and their families are not the only people with these issues and problems. Others, such as treating physicians and supporting scientists, can face corresponding problems.